Individual provider Active NPI

Jonathan R. Welch, DDS

  • General Practice Dentistry
  • Signal Mountain, TN
National Provider Identifier
1083720379
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS8255 Issued in TN
Practice address
1408 James Blvd
Signal Mountain, TN 37377-2630
Phone
(423) 886-3649
Fax
(423) 886-2726
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS8255 TN Primary

Addresses

Primary practice location

1408 James Blvd
Signal Mountain, TN 37377-2630

Mailing address

1408 James Blvd
Signal Mountain, TN 37377-2630
Phone (423) 886-3649

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170208002246 TN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1850674219

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS8255TNMDGeneral Practice Dentistry
8255TNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Welch Dental Center, PLLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083720379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1408 JAMES BLVD",
            "city": "SIGNAL MOUNTAIN",
            "state": "TN",
            "postal_code": "373772630",
            "telephone_number": "423-886-3649",
            "fax_number": "423-886-2726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1408 JAMES BLVD",
            "city": "SIGNAL MOUNTAIN",
            "state": "TN",
            "postal_code": "373772630",
            "telephone_number": "423-886-3649",
            "fax_number": "423-886-2726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELCH",
        "first_name": "JONATHAN",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS8255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Signal Mountain, TN

Sources for this page

Verify at the official NPI Registry.